Quick Start Guide - UnitedHealthcare of MN, ND and SD

Thank you for joining us!

As a new payer in Minnesota, North Dakota and South Dakota, we have an extraordinary opportunity to collaborate with you in serving UnitedHealthcare members in the communities we call home.

We believe the best solutions come from working together to improve the patient experience and health outcomes. Together, we can help people live healthier lives and help the health care system work better for everyone.

Health care providers like you are vital to our success, and we’re here to support you every step of the way. This guide will help you get started. Please let us know how we can help.

We support providers’ operational needs with Link, your portal to the tools and information you need to manage UnitedHealthcare member accounts. This self-service platform includes, but is not limited to, the following tools:

PreCheck MyScript

Get real-time prescription pricing for a patient’s desired pharmacy. It also alerts you to drugs that limit member out-of-pocket costs or when utilization management (prior authorization, quantity limit or step therapy) is required. Learn more about PreCheck MyScript.

Optum ID

Beginning Sept. 1, 2018, all licensed practitioners and facilities contracted with UnitedHealthcare will need to begin credentialing directly with us and complete the process by Feb. 28, 2019.

Sept. 1, 2018 through Jan. 31, 2019, we’ll credential care providers for ongoing participation in our network. We work with Aperture, a credentials verification organization, to complete this process. You may receive communications from UnitedHealthcare and/or Aperture, on our behalf, during this process.

Care providers can start the process today by submitting their credentialing application to the Council for Affordable Quality Healthcare (CAQH) or Minnesota Credentialing Collaborative (MCC).

Option 1: Nationally, UnitedHealthcare is a member of the CAQH. CAQH ProView™ is a web-based credentialing application portal that streamlines the credentialing process for health care professionals. Visit proview.caqh.org/pr to learn more.

Option 2: UnitedHealthcare is now a member of the Minnesota Credentialing Collaborative (MCC), offering ApplySmart, a provider credentialing application website for licensed practitioners practicing in Minnesota, North Dakota or South Dakota. Visit mncred.org for more information on MCC.

Care providers who will be new to serving UnitedHealthcare members after Sept. 1, 2018:

Please follow the credentialing process outlined in our credentialing section at UHCprovider.com/join or call us at 877-842-3210 to request to be a participating care provider:

At the prompt, enter your Tax Identification Number (TIN)

Select Credentialing

Select Medical

Select Join the Network

You will be transferred to a provider service representative who will request information about your practice.

Make sure you are prepared to submit claims and other EDI transactions to UnitedHealthcare.

Visit the EDI section to view the UnitedHealthcare requirements for exchanging electronic data and national standards for electronic data exchange among providers, health care plans, clearinghouses, vendors and other health care business associates.

UnitedHealthcare interacts with many clearinghouses and does not endorse a particular one. However, most of our transactions go through OptumInsight, a clearinghouse owned by Optum, an affiliate of UnitedHealthcare. Optum also interacts with many clearinghouses.

UHC On Air gives you in-depth program information and meaningful updates from UnitedHealthcare 24/7and from any device

Get in Contact for Information and Support

Provider Service Center

UnitedHealthcare’s commitment to building strong partnerships with local providers includes the creation of a provider call center based in Minnetonka, MN. This team will address concerns, answer questions and connect you to available tools and resources to make your job easier. Call 1-877-842 3210, available Monday-Friday from 7 a.m. to 7 p.m. CST.

Provider Network Management Team

Contact this local team if you have questions about your UnitedHealthcare contract.

Provider Relations Team

We are an experienced team that lives and works near you so we can better support you in delivering an excellent patient experience. We are here to help when you’re not able to get what you need from our self-service tools or the Provider Service Center.